高血压患者ACE的基因多态性与血浆AngⅡ水平及其抑制药作用关系研究——附76例检测分析

目的:探讨高血压病患者血管紧张素转换酶(ACE)基因多态性与血管紧张素转换酶抑制药(A-CEI)对血浆中血管紧张素Ⅱ(AngⅡ)水平的影响.方法:高血压病或合并冠心病患者76例、健康对照组52名,应用PCR技术检测ACE基因及用放射免疫法检测AngⅡ水平.结果:高血压病患者血浆AngⅡ水平在ACE基因II,ID,DD型中分别是(102±43)ng/L,(104±44)ng/L,(106±43)ng/L;经ACEI治疗后分别下降为(76±28)ng/L,(76±28)ng/L,(78±29)ng/L.结论:ACE基因多态性与血浆AngⅡ水平无显著性差异(P＞0.05).     

高血压患者ACE的基因多态性与血浆AngⅡ水平及其抑制药作用关系研究

目的探讨高血压病患者血管紧张素转换酶(ACE)基因多态性与血管紧张素转换酶抑制药(A-CEI)对血浆中血管紧张素Ⅱ(AngⅡ)水平的影响.方法高血压病或合并冠心病患者76例、健康对照组52名,应用PCR技术检测ACE基因及用放射免疫法检测AngⅡ水平.结果高血压病患者血浆AngⅡ水平在ACE基因II,ID,DD型中分别是(102±43)ng/L,(104±44)ng/L,(106±43)ng/L;经ACEI治疗后分别下降为(76±28)ng/L,(76±28)ng/L,(78±29)ng/L.结论ACE基因多态性与血浆AngⅡ水平无显著性差异(P＞0.05).     

老年缺血性脑卒中患者血浆血管紧张素转移酶水平及基因插入/缺失多态性

目的:探讨老年缺血性脑卒中的发生与血浆血管紧张素转换酶(ACE)水平及其基因插入/缺失多态性的关系.方法:应用多聚酶链反应(PCR)方法检测ACE基因多态性,同时用比色法测定血浆ACE水平.对89例老年缺血性脑卒中患者和51例老年健康对照者进行比较分析.结果:脑卒中组D等位基因频率显著高于对照组(0.58%vs 0.36%,P＜0.05),DD基因型患者血浆ACE水平亦显著高于对照组[(42.38±16.61)U/L vs(31.28±8.64)U/L, P＜0.05].脑卒中组各基因型血浆ACE水平依次为DD＞ID＞Ⅱ,对照组各基因型血浆ACE水平无显著差异.同时发现卒中组3种基因型中收缩压依次为DD＞ID＞Ⅱ.结论:血浆ACE水平和ACE基因多态性有关,D等位基因是老年脑卒中的基因危险因素.     

肾实质性高血压患者血管紧张素转换酶基因多态性与血管紧张素转换酶活性的研究

目的研究肾实质性高血压患者血管紧张素转换酶(ACE)基因多态性及与ACE活性的关系。方法运用聚合酶链反应技术检测78例肾实质性高血压患者血管紧张素转换酶插入/缺失基因多态性,采用紫外分光光度法测定ACE活性,以87例正常人为对照。结果①患者组基因型分布与对照组不同(P<0.05),其中缺失型(DD型)频率升高(43.6%vs24.1%,P<0.01);②DD型、缺失/插入型(DI型)、插入型(II型)酶活性在对照组分别为(33.8±12.0)U/L、(18.6±7.2)U/L、(13.4±5.0)U/L,在患者组分别为(31.1±10.2)U/L、(26.3±8.0)U/L、(18.4±7.5)U/L,均表现DD型最高,II型最低(均P<0.01);③患者组ACE活性明显高于对照组(25.9±10.4)U/Lvs(20.7±11.2)U/L(P<0.01);两组ACE活性DD型间差异无统计学意义(P>0.05),而DI型间和II型间患者组明显高于对照组(均P<0.01)。结论①DD基因型在肾实质性高血压患者分布频率升高,是高危因素,与其ACE活性增高有关;②肾实质性高血压患者ACE活性升高,增高程度与基因型有关;因此基因型和ACE活性的检测可作为指导治疗的指标。     

血管紧张素转换酶-2在压力超负荷大鼠心肌中的表达及替米沙坦干预的实验研究

目的 探讨血管紧张素转换酶-2(ACE2)在压力超负荷大鼠心肌中的表达,以及替米沙坦对其表达的影响.方法 将8周龄雄性SD大鼠60只随机分为假手术组、模型组和替米沙坦低、高剂量治疗组.制备腹主动脉缩窄动物模型.替米沙坦高、低剂量组大鼠术前1 d开始分别给予替米沙坦10 mg·kg-1 ·d-1和2 mg·kg-1·d-1管饲,假手术组和模型组则饲以等量生理盐水,每日1次,持续3周.3周后留取血浆和心肌组织标本,以放射免疫法检测血浆和心肌血管紧张素Ⅱ(Ang Ⅱ)浓度;以逆转录-聚合酶链反应(RT-PCR)检测心肌中ACE2和ACE的mRNA表达;以蛋白质免疫印迹法(Western blotting)检测其蛋白表达.结果 与假手术组比较,模型组血浆及心肌中Ang Ⅱ浓度明显增高(血浆(495.1±55.6)ng/L比(269.2±39.5)ng/L,心肌(103.6±23.7)ng/g比(49.5±13.5)ng/g,P均＜0.01],用替米沙坦干预可升高其水平(P均＜0.05),高剂量组显著高于低剂量组[血浆(702.2±40.6)ng/L比(612.6±35.5)ng/L,心肌(211.5±21.5)ng/g比(189.6±43.6)ng/g,P均＜0.053.模型组心肌ACE2蛋白及基因表达均增加(蛋白1.164±0.06比0.79±0.04,基因0.54±0.08比0.41±0.04,P均＜0.05).与模型组比较,替米沙坦干预使心肌ACE2表达增加,呈剂量依赖性,其中低、高剂量组ACE2蛋白表达分别增高1.0倍、1.6倍,基因表达分别增高1.3倍、1.6倍(P均＜0.05).模型组ACE蛋白及基因表达显著增加(蛋白2.10±1.07比1.02±0.05,基因1.93±0.09比0.26±0.09,P均＜0.01),替米沙坦对其表达无显著影响(P均＞0.05).结论 腹主动脉缩窄可显著上调心肌ACE和ACE2的蛋白及基因表达;替米沙坦可能通过上调其水平来发挥治疗作用.     

血管紧张素Ⅰ转换酶基因多态性与妊娠高血压综合征的关系

目的:探讨血管紧张素Ⅰ转换酶(ACE)基因多态性与妊娠高血压综合征(妊高征)发病的关系。方法:应用多引物PCR技术检测120例妊高征患者(妊高征组,其中轻度29例、中度31例、重度60例)及110例正常孕妇(对照组)的ACE基因多态性。结果:妊高征组孕妇ACE基因中的II、ID、DD基因型频率分别为20.8%、37.5%、41.7%。对照组孕妇ACE基因中的II、ID、DD基因型频率分别为44.5%、29.1%、26.4%。两组孕妇的DD基因型及D等位基因频率比较,差异有显著性(P<0.05)。妊高征组轻度与重度患者的DD基因型比较,差异有显著性(P<0.05)。回归分析表明,DD基因型及D等位基因与妊高征发病相关。结论:ACE基因中DD基因型是妊高征的易感基因,II基因型是妊高征的保护基因。     

一组河南群体原发性高血压与血管紧张素转换酶基因插入/缺失多态关联研究

目的 研究血管紧张素转换酶(angiotensin-converting enzyme,ACE)基因插入/缺失多态性与原发性高血压病的关系.方法 应用聚合酶链式反应(PCR)技术检测312例原发性高血压患者与正常对照组189例健康受试者ACE基因第16内含子L/D多态性.结果 对照组ACE基因ID、II、DD型频率分别为55.6%、32.8%、11.6%,I、D等位基因频率分别为60.6%、39.4%;原发性高血压病组ACE基因ID、II、DD型频率分别为53.5%、33.0%、13.5%,I、D等位基因频率分别为59.8%、40.2%.原发性高血压病组ACE各基因型和I、D等位基因与正常对照组相比较差异无显著性(P＞0.05).结果 单纯ACE基因Alu片段插入/缺失多态可能不是河南汉族群体高血压病遗传易感性的标记.     

联合检测窒息新生儿脐血降钙素原和D-二聚体的临床研究

目的探讨窒息新生儿脐血血浆D-二聚体(DD)与降钙素原(PCT)联合检测的临床价值。方法分别采用免疫比浊法和免疫荧光分析法测定40例健康新生儿50例(对照组)、40例轻度窒息新生儿(轻度窒息组)、30例重度窒息新生儿(重度窒息组)脐血血浆DD、PCT水平,对各组检测结果进行统计分析。结果轻度窒息组、重度窒息组及对照组脐血DD水平分别为(1 740±265)、(3 164±453)、(612±73)ng/L,PCT水平分别为(8.4±1.7)、(18.3±4.7)、(0.4±0.1)ng/mL。窒息患儿脐血DD和PCT水平均高于健康新生儿(P0.05),患儿脐血DD和PCT水平随窒息程度加重而升高(P0.05)。结论窒息患儿体内存在不同程度的纤溶亢进和细菌感染,且与窒息程度相关联。     

妊娠高血压综合征患者血管紧张素转换酶基因多态性研究

目的探讨血管紧张素转换酶(ACE)基因插入/缺失多态性与妊娠高血压综合征(PIH)的关系。方法应用聚合酶链反应(PCR)检测92例PIH患者及85名正常妊娠者的ACE基因多态性。结果PIH组ACE基因3种基因型频率分别为DD型44.6%、ID型33.7%、Ⅱ型21.7%,对照组ACE基因3种基因型频率分别为DD型18.8%、ID型40.0%、Ⅱ型41.2%;两组的DD基因型及D等位基因频率比较差异有显著性(P<0.05)。结论ACE基因的缺失多态性(DD)可能为妊高征发病的重要遗传因素之一。     

异丙酚对血管紧张素Ⅱ诱导大鼠心肌成纤维细胞增殖的抑制作用及机制

目的探讨不同剂量异丙酚对血管紧张素Ⅱ(angiotensinⅡ, AngⅡ)诱导大鼠心肌成纤维细胞增殖的抑制作用和机制。方法 100只出生1~3 d的Wistar大鼠进行心肌成纤维细胞的分离与培养后,将细胞分为对照组(细胞培养基中加入1 mL含体积分数1%小牛血清的DMEM培养基)、AngⅡ组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ),AngⅡ+异丙酚0.5 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+0.5 mmol/L异丙酚)、AngⅡ+异丙酚1.0 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+1.0 mmol/L异丙酚)、AngⅡ+异丙酚1.5 mmol/L组(细胞培养基中加入1 mL 1.0×10-7 mol/L AngⅡ+1.5 mmol/L异丙酚)。采用MTT法检测各组细胞生长抑制率,采用PCR法检测各组细胞α-SMA mRNA相对表达量,采用Western blot法检测各组细胞总蛋白含量。结果培养48 h,AngⅡ组细胞生长抑制率[(14.23±1.17)%]低于对照组[(23.32±2.15)%]、AngⅡ+异丙酚0.5 mmol/L组[(24.19±1.36)%]、AngⅡ+异丙酚1.0 mmol/L组[(29.25±2.30)%]及AngⅡ+异丙酚1.5 mmol/L组[(31.37±2.19)%](P<0.05),AngⅡ+异丙酚1.5 mmol/L组、AngⅡ+异丙酚1.0 mmol/L组、AngⅡ+异丙酚0.5 mmol/L组细胞生长抑制率依次降低(P<0.05);AngⅡ组心肌成纤维细胞α-SMA mRNA相对表达量(2.05±0.23)、总蛋白含量(225.06±18.66)均高于对照组(0.98±0.12、150.65±11.23)、AngⅡ+异丙酚0.5 mmol/L组(1.78±0.25、197.54±11.56)、AngⅡ+异丙酚1.0 mmol/L组(1.50±0.11、182.51±10.14)和AngⅡ+异丙酚1.5 mmol/L组(1.12±0.05、168.26±11.05)(P<0.05),AngⅡ+异丙酚0.5 mmol/L组、AngⅡ+异丙酚1.0 mmol/L组、AngⅡ+异丙酚1.5 mmol/L组及对照组心肌成纤维细胞α-SMA mRNA相对表达量及总蛋白含量依次降低(P<0.05)。结论异丙酚具有抑制AngⅡ诱导的大鼠心肌成纤维细胞增殖的作用,且随剂量增加,抗心肌成纤维的作用逐渐增强。     

Do angiotensin-converting enzyme (ACE) inhibitors enhance the effect of exercise rehabilitation in patients with hypertension and ACE DD and DI genotypes?

OBJECTIVE: To test whether pharmacologic angiotensin-converting enzyme (ACE) inhibition in carriers of the ACE DD or DI (D, deletion; I, insertion of 287 base pairs) genotypes can simulate the genetic advantage of the II genotype and thereby enhance the conditioning effects of aerobic exercise. DESIGN: Nonrandomized controlled trial. SETTING: Pulmonary institute. PARTICIPANTS: Twelve sedentary men with controlled hypertension (5 with DD genotype, 7 with DI genotype; age, 53+/-7y) treated by ACE inhibitors (study group) and 10 patients (8 men, 2 women; 2 with DD genotype, 8 with DI genotype; age, 54+/-10y) who were treated by other antihypertensive drugs (controls). INTERVENTION: Exercise training. MAIN OUTCOME MEASURES: Training effect was measured by maximal oxygen uptake (Vo(2)max) anaerobic threshold (Vo(2AT)), and the corresponding work rates (WR) (in watts)-WRmax and WR(AT)-before and after 10 weeks of training. RESULTS: Vo(2)max increased by a mean of 10% (200mL/min) and WRmax by 14% (25W) in each group (P<.001). Vo(2AT) and WR(AT) tended to increase more in the study group (Vo(2AT): 10% [186+/-35mL/min] vs 5% [100+/-1mL/min]; P<.006; WR(AT): 19% [19+/-2W] vs 12% [11+/-3W]; P<.03; respectively). CONCLUSIONS: This study did not show an enhancement of exercise-related conditioning by pharmacologic ACE inhibition among hypertensive patients with ACE DD and DI genotypes, comparable to the advantage conferred by the II genotype.     

Increased deformability of red blood cells is associated with a deletion polymorphism of the angiotensin-converting enzyme gene

Angiotensin-converting enzyme (ACE) plays important roles in the renin-angiotensin system. ACE converts angiotensin I to angiotensin II and also inactivates bradykinin, thereby modulating the vascular tone. A polymorphism of the ACE gene, located on chromosome 17, has been found in intron 16, and is characterized by the presence (insertion [I]) or absence (deletion [D]) of a 287-base-pair Alu repeat. Individuals with the D allele of the ACE gene have higher ACE levels and are at higher risk of cardiovascular events. We aimed to investigate the possible relationship between the I/D polymorphism of the ACE gene and hemorheological parameters, including red blood cell (RBC) deformability. The study was performed on 28 healthy young volunteers (13 women and 15 men, mean age 24 +/- 2). The prevalence of the I and D alleles was 30.4% and 69.6%, respectively. The I/I genotype (II) was found in 21.4%, I/D genotype (ID) in 17.9%, and D/D genotype (DD) in 60.7% of the subjects tested. No significant relationship between ACE I/D polymorphism and RBC aggregation or whole blood and plasma viscosity was observed. In contrast, RBC deformability was significantly increased in the subjects with the DD genotype compared with the II (p < 0.05) or the ID (p < 0.01) genotype, and in the subjects with the D allele compared with the I allele (p < 0.01). We suggest that RBC deformability of individuals with the D allele, who have higher risk for cardiovascular pathologies, may have been increased by a compensatory mechanism.     

The link between angiotensin-converting enzyme genotype and pulmonary artery pressure in patients with COPD

OBJECTIVE: The insertion (I)/deletion (D) polymorphism of the angiotensin-converting enzyme (ACE) gene has been associated with an increased risk of cardiovascular diseases. In patients with primary pulmonary hypertension, the homozygous ACE DD genotype is more prevalent than the non-DD genotype. However, the relationship of ACE gene polymorphism to secondary pulmonary hypertension remains unclear, and ethnicity may be one of the factors that can modulate the effects of ACE genotypes reported in different studies. We hypothesized that in patients with chronic obstructive pulmonary disease (COPD) the presence of the D allele in the ACE gene polymorphism is associated with increased pulmonary artery pressure (Ppa). PATIENTS AND METHODS: Bodyplethysmography was used to assess lung function in 66 consecutive patients with COPD; pulmonary artery pressures were determined using echocardiography. ACE gene I/D polymorphism was identified with the polymerase chain reaction. 118 healthy persons served as the control group. All patients and controls were Caucasian. Genotype II was identified in 15 patients with COPD, genotype ID in 31 and genotype DD in 20. In the control group, genotype II was identified in 19 persons, genotype ID in 68 and genotype DD in 31. The distribution of ACE gene polymorphism did not differ between patients and the control group. RESULTS: In patients with COPD, no differences were seen between the three genotype groups in mean age, smoking history, hemoglobin concentrations or ventilometric or blood gas variables. Both systolic and mean Ppa differed significantly between the II, ID and DD groups (Systolic Ppa: 24.4 +/- 2.2 versus 31.3 +/- 2.5 and 36.7 +/- 3.9 mm Hg, respectively, ANOVA, p < 0.05; Mean Ppa: 13.0 +/- 1.5 versus 17.5 +/- 1.4 and 21.2 +/- 2.8 mm Hg, respectively, ANOVA, p < 0.05). In multiple linear regression analysis, the I/D ACE gene polymorphism (p < 0.05), SaO2 (p < 0.05) and the duration of COPD (p < 0.02) were independent predictors of systolic and mean Ppa. CONCLUSION: The results of the study suggest that I/D ACE gene polymorphism is linked to pulmonary artery pressure in Caucasian patients with COPD.     

RNA interference targeting the ACE gene reduced blood pressure and improved myocardial remodelling in SHRs

The purpose of the present study was to investigate the effects on blood pressure and myocardial hypertrophy in SHRs (spontaneously hypertensive rats) of RNAi (RNA interference) targeting ACE (angiotensin-converting enzyme). SHRs were treated with normal saline as vehicle controls, with Ad5-EGFP as vector controls, and with recombinant adenoviral vectors Ad5-EGFP-ACE-shRNA, carrying shRNA (small hairpin RNA) for ACE as ACE-RNAi. WKY (Wistar-Kyoto) rats were used as normotensive controls treated with normal saline. The systolic blood pressure of the caudal artery was recorded. Serum levels of ACE and AngII (angiotensin II) were determined using ELISA. ACE mRNA and protein levels were determined in aorta, myocardium, kidney and lung. On day 32 of the experiment, the heart was pathologically examined. The ratios of heart weight/body weight and left ventricular weight/body weight were calculated. The serum concentration of ACE was lower in ACE-RNAi rats (16.37+/-3.90 ng/ml) compared with vehicle controls and vector controls (48.26+/-1.50 ng/ml and 46.67+/-2.82 ng/ml respectively; both P<0.05), but comparable between ACE-RNAi rats and WKY rats (14.88+/-3.15 ng/ml; P>0.05). The serum concentration of AngII was also significantly lower in ACE-RNAi rats (18.24+/-3.69 pg/ml) compared with vehicle controls and vector controls (46.21+/-5.06 pg/ml and 44.93+/-4.12 pg/ml respectively; both P<0.05), but comparable between ACE-RNAi rats and WKY rats (16.06+/-3.11 pg/ml; P>0.05). The expression of ACE mRNA and ACE protein were significantly reduced in the myocardium, aorta, kidney and lung in ACE-RNAi rats compared with that in vehicle controls and in vector controls (all P<0.05). ACE-RNAi treatment resulted in a reduction in systolic blood pressure by 22+/-3 mmHg and the ACE-RNAi-induced reduction lasted for more than 14 days. In contrast, blood pressure was continuously increased in the vehicle controls as well as in the vector controls. The ratios of heart weight/body weight and left ventricular weight/body weight were significantly lower in ACE-RNAi rats (3.12+/-0.23 mg/g and 2.24+/-0.19 mg/g) compared with the vehicle controls (4.29+/-0.24 mg/g and 3.21+/-0.13 mg/g; P<0.05) and the vector controls (4.43+/-0.19 mg/g and 3.13+/-0.12 mg/g; P<0.05). The conclusion of the present study is that ACE-silencing had significant antihypertensive effects and reversed hypertensive-induced cardiac hypertrophy in SHRs, and therefore RNAi might be a new strategy in controlling hypertension.     

Polymorphism studies of angiotensin converting enzyme gene in chronic glomerulonephritis]

AIM: To investigate the relationship between polymorphism of angiotensin-converting enzyme (ACE) gene and predisposition to chronic glomerulonephritis (CGN) as well as antihypertensive and anti proteinuric response to ACE inhibitors (ACEI) treatment, therapy with angiotensin II receptor antagonists. MATERIALS AND METHODS: Genotype was determined in 57 CGN patients and 113 subjects free of chronic diseases. Effects of ACE gene polymorphism on antihypertensive and antiproteinuric efficiency of ACEI and cozaar were studied in 35 CGN patients on monotherapy. 24-h proteinuria, levels of creatinine, potassium in the serum, arterial pressure, glomerular filtration rate were measured in all the patients. RESULTS: No significant differences were found between incidence of ACE gene genotypes and alleles in patients with CGN and controls. Maximal antihypertensive response to therapy was observed after a month treatment in patients with genotypes II and ID. Lowering of arterial pressure in patients with genotype DD was observed on month 6-12 of continuous therapy. Proteinuria diminished on the treatment month 1-3 in patients with genotypes II and ID, in genotype DD proteinuria rose for the same period of time. Proteinuria dropped similarly in all the groups by month 6-12. CONCLUSION: Relations between ACE gene polymorphism and genetic predisposition to CGN were not found. Patients with genotype II were most sensitive to IACE and cosaar treatment. Lack of an early anti proteinuric response in homozygotes DD does not determine effectiveness of long-term IACE treatment and should not be a reason for the above drug discontinuation.     

ACE gene insertion/deletion polymorphism associated with 1998 World Health Organization definition of metabolic syndrome in Chinese type 2 diabetic patients

OBJECTIVE: Because ACE insertion/deletion (I/D) polymorphism has been shown to be associated with diabetes, hypertension, coronary artery diseases, and diabetic nephropathy, and because plasma ACE concentration has been found to be associated with plasma triglyceride and total cholesterol levels in patients with type 2 diabetes, the goal of this study was to investigate whether ACE gene I/D polymorphism is associated with metabolic syndrome in Chinese subjects with type 2 diabetes. RESEARCH DESIGN AND METHODS: A total of 711 patients with type 2 diabetes and 750 control subjects were studied. The ACE I/D polymorphism was determined by PCR. The definition and criteria of metabolic syndrome used in this study matched those proposed in the 1998 World Health Organization classification. RESULTS: Of 711 patients with type 2 diabetes, 534 (75.1%) fulfilled the criteria for metabolic syndrome. The prevalence of metabolic syndrome in control subjects with II, ID, and DD genotype was 9.4, 11.5, and 15.4%, respectively, and in patients with type 2 diabetes, it was 68.6, 79.2, and 86.1%, respectively. The ACE I/D polymorphism was significantly associated with the syndrome in patients with type 2 diabetes (P = 0.001). When pooling the control subjects with diabetic patients, the prevalence of metabolic syndrome in the whole study group with II, ID, and DD genotype was 37.9, 44.5, and 51.0%, respectively, and ACE I/D polymorphism was still significantly associated with metabolic syndrome (P = 0.003). Diabetic patients with DD genotype were also found to have a higher prevalence of dyslipidemia (II/ID/DD = 43.1/53.1/65.8%, P < 0.001) and albuminuria (36.0/44.6/50.6%, P = 0.018) and to have higher serum triglyceride levels (II, ID, and DD = 155 +/- 114, 170 +/- 140, and 199 +/- 132 mg/dl, respectively, P < 0.05). Control subjects with DD genotype were also found to have a higher prevalence of albuminuria or more advanced nephropathy (II/ID/DD = 5.7/14.0/15.4%, P = 0.001), whereas the prevalence of dyslipidemia was not found to be statistically different in the control group. When pooling control with diabetic subjects, ACE genotype could still be significantly associated with dyslipidemia (II/ID/DD = 34.7/41.3/52.2%, P < 0.001) and albuminuria or more advanced nephropathy (20.3/28.9/33.1%, P < 0.001). Diabetic patients with metabolic syndrome were found to have higher serum uric acid levels than those without metabolic syndrome (6.4 +/- 1.8 vs. 5.3 +/- 1.4 mg/dl, P < 0.01). CONCLUSIONS: The ACE I/D polymorphism was found to be associated with metabolic syndrome in Chinese patients with type 2 diabetes. This finding may provide genetic evidence to explain the clustering of metabolic syndrome and suggests that the renin-angiotensin system is involved in the pathophysiology of metabolic derangement in patients with type 2 diabetes.     

血管紧张素转化酶基因I/D多态性与维吾尔族高血压合并阻塞性睡眠呼吸暂停低通气综合征患者左心室肥厚的关系

目的探讨血管紧张素转化酶(ACE)基因插入/缺失(I/D)多态性与维吾尔族高血压合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者左心室肥厚(LVH)的关系。 方法选取2015年1月至2016年12月于新疆医科大学第一附属医院高血压科首诊住院,且未服用血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)类降压药物的维吾尔族高血压合并OSAHS患者,共72例,行多导睡眠呼吸监测、动态血压、心脏彩超等检查,聚合酶链式反应(PCR)和琼脂糖凝胶电泳技术测定ACE基因多态性。根据左心室质量指数分为左心室肥厚组(LVH组,n＝24)和非左心室肥厚组(NLVH组,n＝48),比较两组间基因型及基因频率的差异,使用多因素Logistic回归分析左心室肥厚的影响因素。 结果高血压合并OSAHS患者LVH组ACE基因型频率分别为：II(37.50%),ID(20.83%),DD(41.67%),等位基因频率分别为：I(48.00%),D(52.00%),与NLVH组[II(47.92%),ID(37.50%),DD(14.58%),I(67.00%),D(33.00%)]比较,差异有统计学意义(χ²＝6.75,4.70;均P<0.05);对左心室肥厚影响因素进行多因素Logistic回归分析,呼吸暂停低通气指数(AHI)(OR＝6.20,95%CI：1.44～26.77;P<0.05)、DD基因型(OR＝4.61,95%CI：1.05～20.31;P<0.05)是维吾尔族高血压合并OSAHS患者发生LVH的独立危险因素。 结论ACE基因I/D多态性与维吾尔族高血压合并OSAHS患者发生LVH有关,其中DD基因型维吾尔族患者更易发生LVH。     

Angiotensin converting enzyme gene polymorphism and glomerular filtration rate changes in type 2 diabetic patients

It has been suggested that an insertion/deletion (I/D) polymorphism in intron 16 of the angiotensin-converting enzyme (ACE) gene may be associated with diabetic nephropathy The aim of this study was to investigate whether an association exists between ACE I/D polymorphism and glomerular filtration rate (GFR) in type 2 diabetes mellitus. A total of 128 type 2 diabetic patients were included in the study with the following ACE genotype distribution: DD 40, ID 58,11 30. I/D polymorphism was determined by polymerase chain reaction (PCR). Mean GFR was not statistically different according to ACE genotype (DD: 89.9 +/- 28.1 ml/min, ID: 99.5 +/- 25.1 ml/min, II: 96.6 +/- 19.6 ml/min). There was no significant difference in genotype distribution in normo-, micro- and macroalbuminuric patients (DD:ID:II [%], normo- 35:46:19, micro-28:55:17, macro- 31:55:14). ACE I/D polymorphism does not seem to be associated with GFR in type 2 diabetic patients.     

ACE gene polymorphism and long-term renal graft function

OBJECTIVES: The long-term outcome of transplanted kidneys has not changed substantially and only a minority of grafts survives more than 15 yr. The aim of this study was to determine the influence of ACE gene polymorphism on long-term outcome after renal transplantation. DESIGN AND METHODS: Using PCR, we evaluated ACE I/D gene polymorphism in a group of patients with long-term graft function (LTF) over 15 yr and compared it with control groups of transplant recipients and population sample. RESULTS: The distribution of genotypes in the LTF group differed from transplant controls (p < 0.05). Moreover, DD homozygotes in the LTF group had better creatinine clearance (DD: 1.1 +/- 0.3, ID: 0.96 +/- 0.3, II: 0.76 +/- 0.3 mL/s; p < 0.05). There were no differences in genotype distribution between transplant and population samples. CONCLUSIONS: Results of our study have demonstrated a possible connection between the DD variant of ACE I/D gene polymorphism and excellent long-term graft function.